Hodges B, Regehr G, McNaughton N, Tiberius R, Hanson M
Department of Psychiatry, Faculty of Medicine, University of Toronto, Ontario, Canada.
Acad Med. 1999 Oct;74(10):1129-34. doi: 10.1097/00001888-199910000-00017.
To evaluate the effectiveness of binary content checklists in measuring increasing levels of clinical competence.
Fourteen clinical clerks, 14 family practice residents, and 14 family physicians participated in two 15-minute standardized patient interviews. An examiner rated each participant's performance using a binary content checklist and a global process rating. The participants provided a diagnosis two minutes into and at the end of the interview.
On global scales, the experienced clinicians scored significantly better than did the residents and clerks, but on checklists, the experienced clinicians scored significantly worse than did the residents and clerks. Diagnostic accuracy increased for all groups between the two-minute and 15-minute marks without significant differences between the groups.
These findings are consistent with the hypothesis that binary checklists may not be valid measures of increasing clinical competence.
评估二元内容清单在衡量临床能力提升水平方面的有效性。
14名临床实习生、14名家庭医学住院医师和14名家庭医生参与了两次15分钟的标准化患者访谈。一名考官使用二元内容清单和整体过程评分对每位参与者的表现进行评分。参与者在访谈开始两分钟时和结束时给出诊断结果。
在整体评分方面，经验丰富的临床医生得分显著高于住院医师和实习生，但在清单评分方面，经验丰富的临床医生得分显著低于住院医师和实习生。所有组在两分钟和15分钟标记之间的诊断准确性均有所提高，组间无显著差异。
这些发现与二元清单可能不是衡量临床能力提升的有效指标这一假设一致。
